During recent months, in which trashing the British National Health Service has become de rigueur among opponents of healthcare reform, I’ve been thinking a lot about my late, beloved Grandma. She died in 1996. But in the early 1990s, knowing that she might not live too many years longer, I asked her if she’d talk on tape about her life history. And Grandma, never a woman reticent to talk about herself, agreed. So, one rainy afternoon in the terraced house she shared with my grandfather in an English seaside town, we sat in her middle room drinking tea from her best china, I placed a tape recorder between us, and she told me about her life.
My grandmother grew up in Marfleet, at that time a village outside the Yorkshire city of Hull. She grew up poor—her father was employed as a dock worker unloading cargo from the ships at the nearby docks on the River Humber—but she regarded herself as well off then because she was among the kids who always had shoes and enough to eat. Grandma had wanted desperately to be a teacher, but there was no money for an education. Instead, she left school as a young teenager to sell sarsaparilla outside the Salt End chemical refinery, a little further up the river from the docks, to the men who worked there, which is where she met my grandfather. Together, they watched the total eclipse of the sun on the morning of June 29th, 1927 outside Salt End, and that evening they went on their first date.
Married on the verge of the Great Depression, like so many of her generation, Grandma had to raise a young family in extreme poverty. Managing a severely underfinanced household carved certain things into her memory: when I interviewed her sixty years later, she could still recall the exact price of butter, potatoes, bread, tea, milk and corned beef, how much the weekly rent was, and the cost of every item of furniture that they bought. She told me about having to scrimp and save to buy the soap and other basic necessities for childbirth, about how having a midwife was a luxury. She talked about how calling out the doctor meant financial disaster, and how, often, she simply could not afford to buy medicine for a sick child.
Then the war came. Just three weeks after the invasion of Poland by Germany, my grandmother’s seventh child (my mother) was born. The next six years involved enduring terrifying air raids (the city of Hull, where Grandma was living, had ninety percent of its buildings destroyed or damaged by German bombs), coping with rationing, having to run a household alone, and dealing with all the privations and difficulties of war.
As I interviewed my grandmother, I imagined how frightened she must have been of a Nazi invasion, how tedious it was to put up the blackout curtains every night, how rationing must have made it even more challenging to feed a large family, and how fearful she must have been for Granddad, who was away, fighting in the Royal Marines. So it was a surprise to me when I asked her, “How did you feel when the war ended, Grandma?” and the first thing she talked about was the National Health Service, put in place by the new Labour government soon after the conflict was over.
More than anything, it was this (along with the child cash allowances and other innovations of the postwar government that shielded British families from the depths of poverty) that transformed my grandmother’s life. After 1945, she never had to worry about not being able to pay the doctor or purchase needed medication for her children. Illness might be a tragedy, but it could no longer plunge her family into severe financial crisis. As she talked about this, all those years later, the relief was still palpable in my grandmother’s voice.
It likely took World War II for Britain to put in place the National Health Service. Before the conflict, Britain had been a rigid class society. The experience of joint sacrifice and unity against a common enemy softened those class barriers. A different understanding of the country’s common welfare emerged. By the time the war ended, all the major political parties were committed to creating a National Health System of some sort. And, because the government had largely done a good job of directing the war effort, it made sense to put it in charge of delivering health services to its citizens as well.
For fifty years of her later life, my grandmother had access to the healthcare she needed. It had become a right, not a privilege—for Grandma and the entire British population. Even during the peak of Margaret Thatcher’s power, when privatization and the rolling back of long-established rights was undertaken in almost every sector, Thatcher understood that the National Health Service was one of the few state-run institutions that Britons would not allow her to destroy.
At the age of eighty-six, a few years after I had interviewed her, my grandma suffered a massive stroke. She was taken to the hospital in a National Health ambulance. She was treated compassionately and kindly, and with great skill by National Health doctors and nurses. There were no death panels or advocates for euthanasia waiting in the wings. The medical personnel tried their best to save her, but two days later, she died. She had lived a difficult, but long and satisfying life.
As my grandmother’s grandchild and an immigrant to the United States from Britain, the way that the U.S. deals with healthcare has long been a source of anger and bewilderment to me. The terms of the current healthcare debate are particularly mysterious. I live in a country that is the richest in the history of the world. And yet, here, people frequently do not seek healthcare for the simple reason that they cannot afford it. Families go bankrupt by the millions as a consequence of illness. People worry that paying for their medications will mean that they have to go without other necessities. Many, for financial reasons, do not access preventive care at all. And yet, opponents of healthcare reform have made Britain’s healthcare system their bete noire? This makes no sense to me. After all, sixty-four years ago, thanks to the National Health Service, my grandmother (and every man, woman and child in Britain) left these problems behind.





It’s a funny world we live in.
